OPUS Expands with Partnership Grant
Just 9 months after our Centre’s inception, OPUS is proud to announce it is already increasing its capacity to perform research surrounding Total Joint Replacement in Australia. Following on from the success of last year’s NHMRC grant round funding, the NHMRC have just announced it will fund a partnership grant worth $1.1 million, with additional in-kind contributions on top of that sum from private funders just as eager to support and see where our research is going.
The research will be led by Associate Professor Michelle Dowsey of the Department of Surgery, and will involve several other OPUS Chief Investigators; Professor Peter Choong, Professor Anthony Scott, Professor Philip Clarke and Doctor Tim Spelman. It will also include collaborations with Professor David Hunter from Sydney University, Associate Professor Simon French from Macquarie University and Doctor Catherine Keating from Medibank, and will capitalise on our stakeholder’s diverse geographical locations.
Chief Investigator and OPUS Early Career Fellow Dr Samantha Bunzli, featured below in "In the Spotlight," will take a lead role in the study. The Partnership project aims to optimise the uptake of evidence-based decision-making in total knee replacement and will be undertaken in collaboration with Medibank Private, St Vincent's Health Australia, and advocacy groups MOVE and the Australian Orthopaedic Association. Upon completion of this work it is expected the results will lead to process and policy changes within the whole of St Vincent’s Hospital Australia, the largest healthcare provider in Australia which spans the entire eastern seaboard.
This is another fantastic illustration of the Australian Government's commitment to increasing health awareness and tackling big health issues domestically, hopefully leading to effects on an international scale.
New Deputy Dean Professor Jane Gunn
This October Foundation Chair of Primary Care Research, Head of the Department of General Practice and Deputy Head of the Melbourne Medical School Professor Jane Gunn was appointed new Deputy Dean of the Faculty of Medicine, Dentistry and Health Sciences.
Jane is past President of the Australasian Association for Academic Primary Care and a member of the NHMRC Research Committee from 2009–2015 and has been a Chief Investigator on more than 63 competitively awarded research grants worth in excess of $AUD40 million. She is also a Director of the Board of the Eastern Melbourne Primary Health Network (EMPHN) and a Director of the Board of the Peter MacCallum Cancer Hospital.
Professor Gunn has a long history of serving the community. She established one of the first practice-based research networks in Australia (VicReN) that supports the conduct of grassroots and multi-centre trial research testing complex interventions in the real-world setting.
Her research has influenced practice and policy via advisory roles to the Australian Government’s Science Priorities, Mental Health Expert Reference Groups and Healthcare Homes initiative.
Taking over from highly regarded Professor Glenn Bowes, Jane will work closely with the Dean Professor Shitij Kapur as trusted deputy. She will have oversight of the Faculty’s Strategic Plan, specifically the areas of people and culture; and engagement and international relations. Jane will also lead several academic operational functions, including the role as Chair of the Faculty Appointments and Promotions Committee, and will represent the Faculty at the University Appointment and Promotions Committee and other key governance forums.
In accepting her new role as Deputy Dean, Jane will resign her positions as Head of the Department of General Practice and Deputy Head of the Melbourne Medical School while retaining her primary care research roles. She will begin her new role in January next year. We’re happy to announce she will still be retaining her role as a Chief investigator within OPUS.
Congratulations New Deputy Dean, Professor Jane Gunn.
OPUS Interns at Work – Outcomes
Through our collaborative links across faculties, within the University of Melbourne and functioning with curriculum guidelines, Internship programs provide us with an enhanced ability to achieve some of the high benchmarks we are setting for ourselves. In July 2017, a group of four Master’s students came together to work on a project for OPUS relating to finding and negotiating communication methods for informing our audience(s) of our progress. Coming from the Faculty of Business and Economics after enrolling in their fast-track Work Integrated Learning (WIL) winter subject 'Melbourne Based Practicum', these students showed they have the organisational and interrogation skills required to satisfy any stakeholder’s needs.
Their final presentation unearthed a number of interesting findings, including those related to online data searching. They found that older age groups were just as likely to source health information online as those below the age of 65. And of those people who are accessing online information, almost 90% are doing it at least once daily.
Dr Google may always have an influence in people’s decision making. So, if people are self-diagnosing, we need to be sure they can get suitable, reliable, trustworthy and accurate information. They also illustrated through OPUS stakeholder interviews that GP’s had a number of sources they could utilise to self-educate for life-long learning, through direct contact or self-study.
Their final finding was the importance of a well-functioning and engaging website and social media communications, with a particular focus on Twitter for social media engagement interactions. Their findings suggest that researchers have very little time to spend keeping up to date with new publications. Twitter is a quick and concise way of filtering through that information during short windows of time.
We look forward to working with the Faculty of Business and Economics in the coming years, where our next project involving management consulting students will be sourcing company sponsorship opportunities for OPUS related events and initiatives.
New OPUS Members – Part 2
As mentioned above, Dr Sam Bunzli will be taking on a larger role as a Chief Investigator in our Partnership grant which is directly linked with our work in Research Stream 2. JP Caneiro is an early career researcher at Curtin University who will be starting with OPUS next July. His PhD involved studying people with chronic low back pain reporting high levels of pain-related fear, where he designed and executed a multiple single-case series to evaluate potential mediators of treatment response from cognitive, emotional, behavioural and sensory dimensions. His post doctoral work will involve implementing this knowledge to evaluate optimised care pathways for people with knee osteoarthritis (OA).
The newest members to join the OPUS team are due to start in February 2018. Jason Trieu is a new surgical resident in the Department of Surgery at the University of Melbourne who will be looking at hospital services, the process within and associated TJR variations to determine the impact this has on the cost effectiveness of surgery. Sharmala Thuraisingam has been working as a Biostatistician since 2015 for the Department of General Practice at Melbourne University. She has a Masters in Biostatistics and a Bachelor’s degree in Mechanical Engineering (with honours). Her PhD will involve the development of a risk stratification tool to determine the risk of progression to TKR in an Australian general practice population. Finally, Penny O’Brien will be joining the Department of Surgery as a part time research assistant as a Qualitative Trials Coordinator for the Melbourne Node of the NHMRC Partnership grant.
A big welcome to all our new members.
Podcast Platform HeyOA on the Horizon
In an effort to further extend the reach of our research and community involvement, OPUS is joining one of the newest engagement mediums on offer in one of the newest and most relevant channels to our research. HeyOA is only 6 months old but has already made an impact in the field of Osteoarthritis. Run by PhD student Kerry Costello of Dalhousie University, Nova Scotia, topics have so far covered collaboration and mentoring by Biomedical Engineer Professor Astephen-Wilson, the recent GaitNET meeting and the future of OARSI, by OARSI President Dr Jeffery Katz. We look forward to joining this new platform early next year where Professor Peter Choong will share OPUS research with the HeyOA international audience and how our work in Australia will affect the world.
OARSI Collaborative Scholarship Deadline
The Osteoarthritis Research Society International (OARSI) is the leading medical society for advancing the understanding, early detection, treatment and prevention of osteoarthritis (OA) through its exclusive dedication to research. OARSI’s passion and area of focus is on OA, a debilitating disease affecting more than 600 million people around the world.
The aim of these scholarships are to provide enriched international and national exchange that will foster the acquisition of skills in specialised scientific methodologies, knowledge translation and dissemination of research. The scholarship will also provide educational, networking and partnership opportunities with preference to those in early career research.
There are multiple scholarships available to students and research fellows who are OARSI members. The award is capped at $6500 (USD) each and can be used for six months of study. These awards may be used to support research at institutions with experience in any form of OA Research. The application deadline is the 31st of December 2017. Research outcomes are expected to be reported at the annual OARSI meeting in 2019.
For a list of possible hosts see the OARSI website projects page or click here to become a host. For more information on eligibility, check the scholarships webpage: https://www.oarsi.org/young-investigators/scholarship-awards
In the Spotlight: Researcher Biography
Name: Dr Samantha Bunzli
Organisation: The University of Melbourne, Department of Surgery, St Vincent’s Hospital
Location: Brisbane, Queensland, Australia.
Career summary: My research involves qualitative methodologies to explore patient experiences of musculoskeletal pain through a cognitive behavioural lens, and the experiences of clinicians treating chronic musculoskeletal pain including Physiotherapists, GPs and Orthopaedic Surgeons. I have methodological expertise in qualitative research and content expertise in cognitive behavioural models and health behaviour theories.
Opus Research and Role: Post doctoral researcher working with A/Prof. Michelle Dowsey and Prof. Peter Choong as a post-doctoral fellow for OPUS. I am involved in qualitative projects across each of the four OPUS research streams. I am also Co-Chair of the OPUS Education and Training Subcommittee.
Awards and achievements: Having completed my PhD in 2016 with Professor’s Anne Smith and Peter O’Sullivan, fellow OPUS members at Curtin University, I am now a Chief Investigator on an NHMRC Partnership grant which feeds directly out of OPUS. I am also the recipient of a Physiotherapy Research Foundation grant and a St Vincent’s Hospital Research Endowment Fund grant. I have co-authored seventeen peer reviewed journal articles and one book chapter.
Hobbies/interests: I like to spend my weekends bushwalking and waking up by the beach in our ‘pop top’ van with my husband and two young children. I have spent lots of time overseas and speak French and Spanish.
Name: Maria C. Inacio, MS, PhD
Location: Adelaide, South Australia.
Contact details: firstname.lastname@example.org
Current workplace role: The Registry of Older South Australians (ROSA), South Australian Health and Medical Research Institute (SAHMRI).
Career Overview: Maria is an epidemiologist with research interests in the areas of population health surveillance systems and utilisation of existing data and informatics to enhance these systems. Between 2004-2015 Dr Inacio worked at Kaiser Permanente, the largest integrated healthcare provider in the US, in the development of orthopaedic registries. She led the development of the largest US Anterior Cruciate Ligament Reconstruction (ACLR) Registry (2005), which records 3,500 cases/year from 250 surgeons, and a Hip Fracture Registry (2013), which monitors cases from >2000 surgeons. At Kaiser Permanente, she led research on leveraging administrative, electronic medical record data, and informatics for population surveillance.
Between 2014-2016 Dr Inacio worked at UniSA leading the medical device unit of an NHMRC CRE on Medicine and Device Surveillance. There she led work on the utilisation of medications to monitor surgical populations, which resulted in 15 publications in 3 years.
In 2016 she was appointed the Principal Epidemiology Advisor for the AOANJRR and Specialist Advisor for the Australian Government Therapeutic Goods Administration. In July 2017, she was appointed manager of the Healthy Ageing Research Consortium at SAHMRI, and charged with the development of the ROSA, which will contribute significantly to healthy ageing in South Australia. She also recently received a NHMRC project grant to link the Australian Orthopaedic Association National Joint Replacement Registry to existing Commonwealth and State Health Authority data to expand the monitoring capabilities of the current registry.
Role within OPUS: Associate Investigator Dr Inacio will have a key role in external validation of the nomogram as outlined in Research Stream 1 and through facilitating our collaborative research with Kaiser Permanente.
Awards and Achievements: In her career, she has received a prestigious national US award and an organisation award for a project she was involved in leading, 3 national and 4 international conference awards and 2 prizes.
Hobbies/Interests: Isabel (my 1 year old) and food! Isabel is the light of our lives and the sweetest baby, who keeps us very very busy. Since moving to Australia I have definitely taken an interest on the food culture here, great wine tastings and food/wine festivals. It helps to be so close to the Barossa Valley.
Michelle Tew Speaker at Australian Health Economics Society Conference in Sydney
Last September one of our newest PhD candidates Michelle Tew spoke at the Australian Health Economics Summit in Sydney. Her research involves using health-related quality of life scores as a predictor of outcomes in total knee replacement patients.
Her talk outlined the demographics for Total Knee Replacement (TKR) and their costs. Even more interesting is the measurement of effectiveness and cost-effectiveness of TKR. What we know is that TKR’s are highly effective surgeries and we can predict the outcomes of TKR based on patient attributes.
Thanks to Professor Peter Choong and Associate Professor Michelle Dowsey our researchers can use the St. Vincent’s Melbourne Arthroplasty Outcomes Registry (SMART) which now has information on over 11,000 surgeries pertaining to Total Joint Replacement (TJR) listed in it. This data covers patients that have undergone TKR since January 2006, covering demographics (age, BMI, socioeconomic status), clinical information (co-morbidities, ASA score), surgical details (date, complications), outcome scores (WOMAC, Knee Society Score) assessment of HRQOL and Date of death (all-cause mortality).
Michelle’s next steps will be to better capture the observed relationship between HRQOL and mortality and to incorporate quality adjusted survival analysis methods into her work. The final aim is to develop a prediction model to aid in better selection of patients with greater total benefit from TKR.
Michelle works out of two centres at the University of Melbourne. The Centre for Health Policy and the School of Population and Global Health and the Department of Surgery, Melbourne Medical School. Her skills are highly valued to OPUS. We look forward to some more results as they come to pass.
Nardia-Rose Klem receives Research Training Program PhD Scholarship
Early this month PhD Candidate Nardia-Rose Klem received news that she had been successful in her application for a Research Training Program (RTP) Scholarship to commence in 2018. The Graduate Research School at Curtin University awarded the three-year Australian Government funded scholarship to support her research into assessing physiological and behavioural elements relating to knee pain and Osteoarthritis.
Moreover, her success in being granted this Government funded scholarship will enable her previously allocated funds to be distributed to other Curtin University students or staff to undertake related OPUS work.
Our recent Medical Degree Research Project (MDRP) student Ben Murphy has had his research accepted for publication in The Journal of Arthroplasty. His publication entitled “What Is the Impact of Advancing Age on the Outcomes of Total Hip Arthroplasty?” highlights the increasing global demand for total hip arthroplasty amongst the elderly. However, it is still unknown how successful this operation is for those who are at the end stages of life. So Ben looked into the risks and benefits for older patients undergoing this procedure.
Using SMART registry data Ben compared the risks and benefits of Total Hip Arthroplasty (THA) in patients older than 80 years of age versus those who were younger than 80. Those above the age of 80 had 3 times greater odds of experiencing a post-operative medical complication and of all-cause mortality. The older group also had an increased length of acute hospital stay and were almost 4 times more likely to be discharged to a rehabilitation facility rather than directly home. Despite the increased risk demonstrated in the elderly, improvements in physical functioning were equivalent across both age groups. This highlights the need to carefully balance the benefits of surgery against the increased risk of adverse outcomes when considering THA in older patients.
Ben also received a merit award for his oral presentation on his research at this year's St Vincent’s Surgical Forum.
If you’re interested in more details, methods or information regarding Ben's research you can check it out here:
Last month, the combined efforts of five OPUS researchers resulted in the BMJ Open publication: “Barriers and facilitators to orthopaedic surgeons’ uptake of decision aids for total knee arthroplasty: a qualitative study”. Qualitative research is an emerging area in Orthopaedics, and this unique study involving one-on-one interviews with Orthopaedic Surgeons is one of only a few such studies in the literature.
The use of decision aids can assist surgeons in determining if a specific patient is likely to respond to Total Knee Arthroplasty (TKA) or not, and assist patients in weighing up the risks and benefits of surgery. Before implementing a decision aid into clinical practice, it is important to understand why or why not surgeons might use one. So, we designed a qualitative study to find out.
We performed twenty face-to-face interviews for orthopaedic surgeons who regularly perform TKA in a Melbourne hospital using questions constructed on the Theoretical Domains Framework to explore the barriers and facilitators to using a decision aid. Their responses were grouped together as themes. We discovered that most surgeons perceived their own patient outcomes were better than those described in the literature but most acknowledged a lack of objective feedback about their patient outcomes. Surgeons expressed difficulty assessing patient-related factors known to influence TKA outcomes, relying on their ‘gut-feelings’ about the patient. While the surgeons first prioritised their own skills and judgement in making decisions, they believed decision aids could enhance communication and patient informed consent. Concerns were expressed that decision aids could lead to mandatory cut-offs that would exclude some patients from surgery. Cut-offs that surgeons considered ‘acceptable risk for non-response’ were patient-dependent. When considering this risk, surgeons also took into consideration the perceived lack of effective alternatives to surgery
Now that we know the basic limitations for uptake of decision aids, we can plan multifaceted strategies to ensure orthopaedic surgeons can and will use a TKA decision aid. Audit/feedback methods and policy change could be reviewed and implemented to address current decision-making biases and to increase uptake. It may also be important to ensure there are avenues surgeons can access to provide effective non-operative treatments for end-stage osteoarthritis which may also enhance uptake.
You can check out this open-access publication here:
Key Consumer Advocate to Visit Melbourne
Next May, we are looking forward to welcoming Rheumatologist and OMERACT board member Professor Jasvinder Singh to our central node at the Department of Surgery in Fitzroy, Melbourne. Professor Singh brings to us a wealth of knowledge surrounding the needs of patients and how they do and should intersect with our research. He will be here for a week in May to undertake research and while he is here we anticipate he will provide a consumer-focused lecture about how his work relates to OPUS and what you can do to help.
His visit also coincides with the OMERACT conference in Terrigal Australia, an independent initiative of international health professionals interested in outcome measures in rheumatology. We look forward to seeing Professor Singh very soon.
Melbourne-Based Teleinterview Training
Early next year, two of our satellite research members will come together at the Department of Surgery in Fitzroy to plan, train and carry out a large number of teleinterviews for research stream 3. Dr Samantha Bunzli and PhD candidate Nardia Rose-Klem will be here for 1 and 5 weeks respectively to undertake their research.
It will be one of many instances in the next 5 years which will involve cross-country collaborative research and mentoring, where video conferencing methods won’t quite suffice. The next planned instance is likely to be late next May when all our OPUS Executives will meet for our Quarterly meeting, accompanied by our annual Stakeholder Advisory Council members.
Melbourne 2019 - OPUS Forum
Planning has already begun to hold our inaugural OPUS Forum, a collaborative platform put in place to aid us in explaining our research to you. We’re aiming to focus on multiple audiences including Surgeons, General Practitioners, Allied Health professionals, industry, government and general community members. There are big things to come so keep an eye out on this space!
OPUS plans to make a big impact in the field of musculoskeletal research in the next 5 years and beyond. We plan to share that research with you at every stage, feeding back our plans to the community as quickly and efficiently as possible. To do this we are making the most of social media channels Twitter, Facebook, LinkedIn and YouTube. You can also get information directly through our interactive website. Read on to find out how far we have come in such a short period of time.
The report completed by our Melbourne Based Practicum intern students suggested we should pay particular attention to utilising our Twitter social media feed and other related social media platforms for engaging research stakeholders and building capacity in the social media space. Highlighting our research, inspirational leaders and their abilities to impact on the community and national economy is valuable community news. We have also paid particular attention to improving our website for better accessibility of information and resources and look forward to improving the degree of resource allocation we can provide.
Total Website views in the first 6 months = 1776
The OPUS web resource is the 3rd most viewed page for the Department of Surgery
The OPUS news items page is the 18th most viewed page for the last 3 months for the Department of Surgery
The OPUS home page is ranked 61st most viewed page (out of 5,847) for the Melbourne Medical School website over the last 3 months
The Melbourne Medical School website (Where OPUS sits) is the 2nd most visited site after the Faculty’s Study Hub (93,000 session) for the last 3 months
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Your feedback on any aspect of our project is always welcome. You can send us a message through Twitter @unimelbOPUS, join our mailing list here or contact our Centre Manager directly.
Dale Baum: email@example.com
T: +61 3 9231 2553 M: +61 435 697 011
Department of Surgery, Melbourne Medical School, St. Vincent’s Hospital